JACKSON CHIROPRACTIC CLINIC PC
NPI 1073662680
Chiropractor in Edmond, OK
About Jackson Chiropractic Clinic Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACKSON CHIROPRACTIC CLINIC PC (NPI 1073662680) is a healthcare organization registered as a chiropractor in Edmond, Oklahoma and active in the NPI registry since January 2007. The organization lists Troy W Jackson, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jackson Chiropractic Clinic Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Jackson Chiropractic Clinic PC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jackson Chiropractic Clinic PC's NPI number?
The NPI number for Jackson Chiropractic Clinic PC is 1073662680. It was assigned to this organization in the NPPES registry on January 10, 2007.
Where is Jackson Chiropractic Clinic PC located?
Jackson Chiropractic Clinic PC is located at 3801 S Boulevard St, Edmond, OK 73013. The listed phone number is (405) 330-6655.
What is Jackson Chiropractic Clinic PC's specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Jackson Chiropractic Clinic PC enrolled in Medicare?
Yes. Jackson Chiropractic Clinic PC is registered in the Medicare PECOS enrollment system.
When is Jackson Chiropractic Clinic PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Oklahoma, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Jackson Chiropractic Clinic PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Jackson Chiropractic Clinic PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Jackson Chiropractic Clinic PC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jackson Chiropractic Clinic Pc · NPI 1073662680
Chiropractor organization in Edmond, Oklahoma. Organization record, active in the CMS NPPES registry since January 10, 2007.
## Identity
- **NPI:** 1073662680 (Entity type: Organization)
- **Enumerated:** January 10, 2007
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **Organization subpart:** No
- **Authorized official:** Troy Jackson, PRESIDENT
## Practice location
- **Address:** 3801 S BOULEVARD ST, Edmond, OK 73013-5479
- **Phone:** (405) 330-6655 · **Fax:** (405) 340-3531
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Oklahoma, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Chiropractic) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 22, 2020
---
Source: [NPI Profile](https://npiprofile.com/npi/1073662680) · Data from the CMS NPPES public registry.